Seizure recurrence following epilepsy surgery: is post-operative EEG helpful?
OBJECTIVE
We examined whether the relationship between interictal epileptiform discharges (IED) on post-operative EEG and seizure recurrence after epilepsy surgery was different in patients with neocortical and mesiotemporal resections.


METHODS
We reviewed the records of 93 consecutive patients who underwent epilepsy surgery at our center and who had adequate post-operative follow-up and a post-operative EEG to determine the type of surgery, the recurrence of seizures and the presence of IED on post-operative EEG.


RESULTS
Chi-square test revealed that for the entire group, there was a significant relationship between the presence of IED and seizure recurrence. However, this relationship was significant in neocortical surgery but not in mesiotemporal surgery. Time distribution of seizure recurrence revealed that in more than half the cases, seizures recurred with the first 3 months. Time distribution was not influenced by the presence of IED.


CONCLUSIONS
This study revealed that IED on early post-operative EEG correlate with seizure recurrence in neocortical but not mesiotemporal surgeries and may be used to guide patient counseling in this group of patients.
Ghacibeh
Georges A
GA
Hackensack University Medical Center, Comprehensive Epilepsy Center, Hackensack, NJ 07601, USA. gghacibeh@gmail.com
Smith
Jeffrey D
JD
Roper
Steven N
SN
Gilmore
Robin
R
Eisenschenk
Stephan
S
D000927:Anticonvulsants / Q000627:therapeutic use; D002540:Cerebral Cortex / Q000503:physiopathology / Q000601:surgery; D016009:Chi-Square Distribution; D004569:Electroencephalography; D004827:Epilepsy / Q000188:drug therapy / Q000503:physiopathology* / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D019635:Neurosurgical Procedures / Q000379:methods; D011184:Postoperative Period; D012008:Recurrence; D012189:Retrospective Studies; D012640:Seizures / Q000503:physiopathology*; D013997:Time Factors
D000927:Anticonvulsants